The evaluation of medical and economic indices of paliative care in oncologic patients


Klin Onkol 2007; 20(2): 209-214.

Changes in our society and, consequently, in our Health Care System during the 15 years after 1989 have brought many important modifications. The definitely positive changes are greater autonomy and actual health services coming closer to the model of effective care for an individual patient. However, we are not prepared for these necessary changes - economical, ethical and social. That is why every
effort is praiseworthy to find and establish such organizational measures to meet the needs of today’s society. A total of 118 oncologic in-patients were admitted to this study, 110 men (93.2%) and 8 women (6.8%). Mean age of the male patients was 57.2 years (range 21-82 years) and mean age of the female patients was 52.3 years (range 37-73 years). Economic evaluation in this group of patients
showed that palliative care was more expensive than radical therapeutic regimens given to the rest of the treated patients. In the years 2004 and 2005 expenses calculated for 1 nursing day per 1 patient with palliative care were 2411 Czech Crowns versus 2155 Czech Crowns in other patients. Mean expenses for „care by request“ in palliative care patients were 955 Czech Crowns versus 973 Czech
Crowns in the rest, practically the same amount in both groups. This also supports the presumption that the patient on palliative care requires at minimum the same expenses as are needed for diagnosis (restaging) and therapy of patient’s actual condition - in oncologic disease also side-effects are included, should the therapy be well targeted. No significant differences were recorded evaluating numbers of given transfusions. In this study, the main objective was to find and define several important medical, economical, quantitative and qualitative factors, which characterize the activity of our oncologic therapy and closer palliative care provided at the in-patient part of an oncologic ward. The results obtained may allow to improve this care but also help to create economic conditions for its realization without decreasing its quality. Initial processed data will be needed for negotiations with health insurance companies, too.